Monday, January 31, 2011

‘There were miracles everywhere’

Seeing graphic images of patients injured during last year's earthquake in Haiti isn’t exactly what I'm used to after eating breakfast, but, wow, Paul Auerbach, M.D., delivered one heck of an opening keynote at the 24th Annual Health Forum and American Hospital Association Rural Health Care Leadership Conference.

Auerbach is a professor of surgery at Stanford University School of Medicine. He flew with a team of fellow clinicians immediately after the quake last January to provide much needed medical care at University Hospital in Port-au-Prince. I can't do justice to their story in this blog. We've all read about and seen videos of the devastation and the heroic efforts to medical professionals from around the world. But hearing Auerbach retell his experiences was a real eye opener given the debates we are currently having over health care in this country.

He talked about seeing between 500 – 1,000 new patients a day and often the very best care they could provide was to amputate a limb (he noted that he could work in the Stanford ED for weeks at a time and not hear a patient say, "Thanks," but every patient he saw in Haiti said it). Many of those procedures were done without pain medicine, which Auerbach said they ran out of in the first six hours of his deployment. There were no CT scans or X-rays; all diagnosis were made by seeing and touching. "It was some of the best medicine I ever got to practice," he said. The clinicians went on instinct. There was no place to put waste or trash; it piled up outside.

Eventually, though, things began to take shape: Five ORs were established, there was a TB ward, a 24-hour pharmacy, a lab for point of care testing, dialysis, a maternity ward, a 30-bed ICU. Keep in mind that nearly all of these "departments" were in tents or destroyed parts of the hospital. But the point is Auerbach, his team from Stanford and all of the other serving at University Hospital refused to let adversity slow them down. One of the biggest leadership lessons he learned, in fact, was to "stay in motion and seek out problems," because if wait for the problem to find you, it'll be too big by then.

More than one person remarked during a break how Auerbach reminded them of why they got involved in health care to begin with: to make a difference. And this: leaders lead. They don't sit on the sidelines or run from trouble. Auerbach is now working to establish an effective emergency medical system in Haiti.

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Matthew Weinstock
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January 30 – February 2, 2011
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The 2011 Rural Health Care Leadership Conference brings together top thinkers in the field, and offers proven strategies for accelerating performance excellence and improving the sustainability of rural hospitals in the post-reform environment.

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